The rating system has been criticized by dialysis providers and patient groups since it first was announced in July 2014

The Centers for Medicare & Medicaid Services has added the star ratings to the Dialysis Facility Compare website. The rating system has been criticized by dialysis providers and patient groups since it first was announced in July 2014. But CMS has stood by its rating system.

“Star ratings are simple to understand and are an excellent resource for patients, their families, and caregivers to use when talking to doctors about health care choices,” said CMS Administrator Marilyn Tavenner in a press release. “CMS has taken another step in its continuous commitment to improve quality measures and transparency.”

But some renal organizations do not agree that the system is easy to understand. “Today for the first time consumers are able to examine the new star ratings on Dialysis Facility Compare, which after initial review only reinforces Dialysis Patient Citizens’ concern over the effectiveness of this program in its current form,” Dialysis Patient Citizens said in a news release. “For example, a dialysis patient who searches for facilities in Charleston, W.V. will find that there are only one-star facilities within 50 miles, a situation that appears to have more to do with the fact that West Virginia ranks 49th among states in life expectancy than with the quality of care delivered in its dialysis clinics. In fact, to access the nearest five-star facility, this dialysis patient would have to travel out-of-state more than 74 miles three times a week to receive treatment. As a result, we do not believe that CMS’ current star rating methodology will empower consumers to act on quality information in a realistic manner.”

Dialysis Patient Citizens said they are also disappointed that Dialysis Facility Compare does not contain language that explains a one-star rating does not mean a patient will receive poor care from a dialysis facility. “We are also extremely disappointed that CMS appears to have reneged on an important promise it made last October, to inform Dialysis Facility Compare visitors that ‘a one-star rating does not mean you will receive poor care from a facility.’ We cannot find this essential language anywhere on its website. It is critical that patients understand that all dialysis facilities provide life-sustaining treatment, and that they should not be alarmed or discouraged if higher-rated facilities are not available in their area.”

The DFC rating gives a one to five-star rating based on information about the quality of care and services that a dialysis facility provides. Currently, nine quality measures are being used collectively to comprise the DFC star ratings. CMS said will add more measures in the future.

Standardized Readmission Ratio
CMS also announced that it plans to add the Standardized Readmission Ratio (SRR) for dialysis facilities to the publicly reported quality outcome measures available on the compare website. SRR is a measure of care coordination and is not included in DFC’s star rating at this time.

CMS said it plans to update the DFC’s star rating on an annual basis beginning in October 2015.

Nephrology News & Issues covers the latest developments in nephrology and provides a forum for the exchange of ideas among the professional disciplines responsible for delivering care to the ESRD patient.